Acute lower respiratory infections are the most common causes of serious illness and death in children in PNG, accounting for 30-40 percent of all hospitalisations, the medical symposium in Goroka was told.

Professor Trevor Duke from the Centre for International Child Health at the University of Melbourne in Australia said this in his presentation on respiratory disease in PNG children. Pneumonia, the commonest cause of respiratory infections is particularly prevalent in highlands provinces, he said.

The major bacteria causing pneumonia are streptococcus pneumonia and haemophilis influenzae, viruses, particularly respiratory syncitial virus and influenza are also common and may be associated with secondary bacterial infection, Prof Duke said.

Prof Duke said in the last 10 years with the increase in HIV infection, other pathogens are increasing in prevalence.

In HIV affected children haemophilis influenza and streptococcus pneumoniae are still the most common causes, however pneumocystis jiroveki, staphylococcus aureus, and enteric gram negative bacilli are also found more commonly in HIV-infected than HIV-uninfected children.

"Measles doesn’t go away, and most deaths are from pneumonia. Tuberculosis is also a common pathogen in HIV-infected and uninfected children. Other high risk groups for pneumonia mortality are children with malnutrition, neonates and young infants," he said.

Avoiding these risk factors and promoting protective factors is crucial to prevention of pneumonia, he said.

The risk factors include indoor air pollution, smoke from fires for cooking or warmth inside poorly ventilated houses, parental smoking, low birth weight and prematurity, lack of breast feeding, and feeding of solids and semisolids in the first weeks or months of life, a common practice in the highlands, he said.